The role of bladder diverticula in the prevalence of acute urinary retention in patients with BPH who are candidates to surgery

The urinary bladder diverticula (BD) secondary to benign prostatic hyperplasia (BPH) is a complication that can lead to urinary stasis, stone, urinary tract infection (UTI) and tumors. It's role in acute urinary retention (AUR) is not totally understood.

To determine the effect of BD size on AUR rates in patients with BPH candidates to surgery.

We performed a retrospective cohort study of 47 patients with BPH and BD who underwent BPH surgery associated to complete bladder diverticulectomy from 2006 to 2016. We analyzed risk factors for AUR in patients with BD using univariate, multivariate and correlation analysis.

There was a difference in the size of the diverticula, with 6.8 cm vs. 4.5 cm among patients with and without AUR respectively (p=0.005). The ROC curve showed a correlation between the size of BD and the risk of AUR. The value of 5.15 cm presented a sensitivity of 73% and a specificity of 72%. The area under the curve was 0.75 (p=0.01). Comparing groups with BD >5.0 cm vs. ≤5.0 cm, the AUR incidence was 74% and 27.8% respectively with an OR of 2.65 (1.20-5.85) (p=0.005). In the multivariate analysis, only the size of the diverticula reached statistical significance (p=0.012).

The diameter of BD is an independent risk factor for AUR in patients with BPH and BD who are candidates to surgery. A diameter greater than 5.15 cm increases the risk of AUR.

International braz j urol : official journal of the Brazilian Society of Urology. 2018 Mar 15 [Epub ahead of print]

Alexandre Iscaife, Gabriel Dos Anjos, Cristovão Barbosa, Willian Carlos Nahas, Miguel Srougi, Alberto Azoubel Antunes

Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo - FMUSP, SP, Brasil.

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